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一项关于外用 Janus 激酶抑制剂治疗白癜风的文献综述

A Literature Review Investigating the Use of Topical Janus Kinase Inhibitors for the Treatment of Vitiligo.

作者信息

White Christopher, Miller Richard

机构信息

Dr. White is with Dermatology Partners in Strongsville, Ohio.

Dr. Miller is with the Department of Dermatology, HCA Healthcare/USF Morsani College of Medicine and the Largo Medical Center, in Largo, Florida.

出版信息

J Clin Aesthet Dermatol. 2022 Apr;15(4):20-25.

Abstract

BACKGROUND

Vitiligo is a disfiguring disease that frustrates both patients and clinicians due to its difficulty to treat. Topical Janus kinase inhibitors (TJKI) may offer an alternative treatment option that are safe and well-tolerated for all anatomic sites.

OBJECTIVE

The objective of this review was to evaluate the published clinical reports regarding the use of TJKI for the treatment of vitiligo and to summarize the formulations, dosing strategies, efficacy, and safety of this emerging therapeutic class.

METHODS

This is a review of the National Library of Medicine (via PubMed) and Scopus through April 2021.

RESULTS

The initial search revealed 45 potential articles; eight articles comprising 201 total patients met our inclusion criteria. Our analysis indicates that TJKI offer a viable therapeutic alternative, with similar efficacy to topical corticosteroids (TCS) and topical calcineurin inhibitors (TCI). The beneficial effects of TJKI are most pronounced on facial skin and when combined with narrow-band ultraviolet B (NB-UVB) therapy.

LIMITATIONS

Many publications reporting the use of TJKI have small sample sizes and do not use standardized scoring systems to evaluate disease extent and treatment response.

CONCLUSION

Vitiligo remains a difficult disease to treat, and TJKI are an appealing new treatment option. While the aggregate data on the topic remain sparse, we offer a synthesized review of the literature to date and a glimpse into the ongoing investigations regarding this emerging drug class.

摘要

背景

白癜风是一种毁容性疾病,因其治疗困难,令患者和临床医生都倍感沮丧。外用Janus激酶抑制剂(TJKI)可能提供一种替代治疗选择,对所有解剖部位都安全且耐受性良好。

目的

本综述的目的是评估已发表的关于使用TJKI治疗白癜风的临床报告,并总结这一新兴治疗类别的制剂、给药策略、疗效和安全性。

方法

这是一项通过2021年4月对美国国立医学图书馆(通过PubMed)和Scopus进行的综述。

结果

初步检索发现45篇潜在文章;8篇文章共201例患者符合我们的纳入标准。我们的分析表明,TJKI提供了一种可行的治疗选择,其疗效与外用糖皮质激素(TCS)和外用钙调神经磷酸酶抑制剂(TCI)相似。TJKI对面部皮肤的有益作用最为明显,且与窄谱中波紫外线(NB-UVB)疗法联合使用时效果更佳。

局限性

许多报道使用TJKI的出版物样本量较小,且未使用标准化评分系统来评估疾病范围和治疗反应。

结论

白癜风仍然是一种难以治疗的疾病,而TJKI是一种有吸引力的新治疗选择。虽然关于该主题的总体数据仍然稀少,但我们提供了迄今为止文献的综合综述,并对有关这一新兴药物类别的正在进行的研究进行了一瞥。

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引用本文的文献

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The Anti-Vitiligo Effects of Feshurin In Vitro from and the Mechanism of Action.
Pharmaceuticals (Basel). 2024 Sep 23;17(9):1252. doi: 10.3390/ph17091252.
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Management of Stable Vitiligo-A Review of the Surgical Approach.
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本文引用的文献

1
Topical Tofacitinib: A Janus Kinase Inhibitor for the Treatment of Vitiligo in an Adolescent Patient.
Case Rep Dermatol. 2021 Apr 1;13(1):190-194. doi: 10.1159/000513938. eCollection 2021 Jan-Apr.
2
Two cases of vitiligo vulgaris treated with topical Janus kinase inhibitor delgocitinib.
Australas J Dermatol. 2021 Aug;62(3):433-434. doi: 10.1111/ajd.13572. Epub 2021 Mar 5.
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Off-label Studies on the Use of Ruxolitinib in Dermatology.
Dermatitis. 2021;32(3):164-172. doi: 10.1097/DER.0000000000000658.
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Vitiligo: an update on systemic treatments.
Clin Exp Dermatol. 2021 Mar;46(2):248-258. doi: 10.1111/ced.14435. Epub 2020 Dec 22.
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Association of myalgias with compounded topical Janus kinase inhibitor use in vitiligo.
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Tofacitinib cream plus narrowband ultraviolet B phototherapy for segmental vitiligo in a child.
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Repigmentation in vitiligo using janus kinase (JAK) inhibitors with phototherapy: systematic review and Meta-analysis.
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